The Objective of this invitational conference is to define staffing issues and the relationship of staffing to quality in the delivery of health services in nursing homes (long term care facilities) and to develop a strategy for studying these staffing issues. The specific aims as they relate to nursing homes are to: 1) develop consensus on the major issues about staffing and the relationship between staffing and quality considering case mix. 2) identify methodological problems and issues in designing studies to assess the relationship between staffing and quality considering case mix. 3) identify priority areas for research on the relationship between staffing and quality considering case mix. The approximately 25 participants at the invitational conference will include: health services researchers who are experts in the delivery of care in nursing homes, experts in health workforce research, consumers, and government representatives (e.g., HCFA, AHCPR, Bureau of Health Professions of HRSA). A manuscript synthesizing the specific questions and methodological approaches will be prepared by Dr. Harrington, Dr. Kovner and others. The manuscript will be submitted to a journal such as Health Affairs or the Journal of the American Geriatric Society. At least one presentation will be made at a professional meeting.